Provider Demographics
NPI:1750487336
Name:RANJAN, CAIN (MD)
Entity Type:Individual
Prefix:
First Name:CAIN
Middle Name:
Last Name:RANJAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CASTLE WALK
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3221
Mailing Address - Country:US
Mailing Address - Phone:914-966-1430
Mailing Address - Fax:914-595-4982
Practice Address - Street 1:970 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1309
Practice Address - Country:US
Practice Address - Phone:914-966-1430
Practice Address - Fax:914-595-4982
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206587207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01614699Medicaid
NY45J871Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NYG18211Medicare UPIN